Self-neglect, the inability to provide for oneself the goods or services to meet basic needs, is three times more common than physical abuse or caregiver neglect. Over the past decade our academic geriatrics team has successfully collaborated with Adult Protective Services (APS) to intervene in cases of vulnerable, at-risk elders who self-neglect. Despite the great successes of this collaboration, there is no empirical evidence citing the effectiveness of coupling the Comprehensive Geriatric Assessment Intervention (CGAI) with APS intervention versus APS intervention alone in the management and remediation of elder self-neglect. We plan to conduct a randomized clinical trial (RCT) to test if CGAI and APS intervention is superior to APS intervention alone. Specifically, we plan to recruit 100 APS substantiated cases of elder self-neglect, ages 65 or older, and randomly assign them to either the CGAI and APS intervention group or the usual APS intervention group. Data related to self-neglect status, social, physical, medical and cognitive status and health care utilization and mortality will be collected at baseline and again at 6 months. We intend to test the hypothesis that this approach will improve the quality of care and outcomes provided to these seniors by state protective service agencies.